19843_CHAMBERS, NORM & LINDA_19981023

CAMA AND DREDGE AND FILL 4
GENERAL ,� n1,9t843_ `�
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name
Address
City �_ t o
Project Location (County, State Road, Water Body, etc
Type of Project Activity
State
PROJECT DESCRIPTION SKETCH
Pier (dock) length —
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
t
' t
Phone Number
Zip � �l_ I ??
(SCALE: )
t
to compliance with this application, site
This permit is subject p pp ,
f
C
drawing and attached general and specific conditions. Any CYL
V
violation of these terms may subject the permittee to a fine,
applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void.
This permit must be on the project site and accessible to the
permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
issuing date expiration date
ordinances, and 2) a written statement has been obtained from
I
adjacent riparian landowners certifying that they have no
f, objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that
this j roect is consistent with the North Carolina Coastal application fee
project
Management Program.
i

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certi
lI
property located at -
that I own property adjacent to a;:'� C/pl1'; 's
/ n (Nme of Pgoperty Owner)
on
(Loy B1i Road, etc,y� ! '
in Le- jL NC.
aterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that
location, and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
' ice 1J,4 Ot.
/ e
� 4
v�
n—f or Iype Name,
e ep one INUMDer
`� Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to yl-�Rrr\ u8eL� 's
ff 1 ^ (NMe of Pfoperty Owner)
property located at' r c,
(Lot, Block, koad etc.)
S�lu I .
aterbody)
(Town and/or County)
on
NC.
He has described to me as shown below, the development he is proposing at that
location, and, I have no objections to his proposal.
------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
X Io's
�- 3 zb co, a I I
Sigitature
V� _ � o d
r n or ype ame
I e ep- one um- er U
Date: " a - 9 - i 9

s . fl l�► n T
Location: CLAL,-�e_ Field Rep.
,
Phone: �1�='2 Date of FEport:
Description of Project:
Date Project Reportedly Compl`'ete:
(1)' Do the measured dimensions of the dEVE ent differ from those
indicated in the permit .and work ?, es / No Have all permit
conditions been satisfied? Yes / No
(2)
Sellnentation ang' Erosion Control: Has FErmit' Eccdef grassed,
or CE.ner'wlse St.a_i1iZed all disturbef areas: Ke-
_ / NO
CO?L'�:ENT :
(3) Future Monitoring and Znfcrceme Ction: is r fL'rzher inVestica ti OP_
Or EnforCEME?7t action needed? Y NO
COUNT: